HomeMy WebLinkAboutChange Order No 1 - Mishawaka Ave Traffic Signals at Fire Station No 9 Project No 117-120A - Pemberton Davis Electric Inc227 W. JEFFERSON BOULEVARD
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CITY OF # BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
July 23, 2019
John Ferro
Pemberton Davis Electric, Inc.
916 E. McKinley Avenue
Mishawaka, IN 46545
PHONE 574/235-9251
FAX 574/235-9171
RE: Change Order No 1 - Mishawaka Avenue Traffic Signals at Fire Station No. 9 —
Project No. I I7-120A
Dear Mr. Ferro:
The Board of Public Works, at its meeting held on July 23, 2019, approved the above
referenced Change Order for an increase of $16,638.57, bringing the current contract amount
to $187,923.94.
Enclosed is a copy of the Change Order for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
Linda M. Martin, Clerk
Enclosure
GARY A. GILOT GENEVIEVE E. MILLER ELIZABETH A. MARADIK LAURA L. O'SULLIVAN THERESE J. DORAU
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE:
PROJECT NO:
PROJECT NAME:
CONTRACT DATE:
CHANGE ORDER NO:
SUBJECT OF CHANGE ORDER:
6/25/2019
117-120A
Mishawaka Avenue Traffic Signals at Fire Station #9
2/26/2019
PCR #1-Bore 3" Conduit PCR #2-Install Handholes PCR #3-
Increase Quantities; Sidewalk Removal and Curb Ramp
Replacement
The original contract sum
Net change by previously authorized change orders
The contract sum prior to this change order
By this Change Order, the project amount is
The new contract sum including this change order
This Change Order represents a total change of
Total change for entire project
Original contracted completion date/time
Extension of date/time by previous change orders
Date/time extension by this change order
New completion date/time
Co ractor Sig
Printed Name and Title
Pemberton Davis Electric, Inc.
Company Name
916 E. McKinley Avenue
Address
Mishawaka, IN 46545
City, State, Zip
$
171,285.37
$
0.00
$
171,285.37
IrR11 Increased
El Decreased
$
16,638.57
$
187923.94
9.71 %
9.71 %
7/17/2019
0 days
0 days__
7/17/2019
CONST
ON MANAGER
CITY OF SOUTH BEND
BOARD OF PUBLI 4iy0 KS
Approved Date:
Gary A. Gj ot, President
Genevie E. Miller, tuber
Elizabeth A. Maradik, Member
IM w
ura O'Sullivan, M
DEPARTMENT OF PUBLIC WORKS
DIVISION OF ENGINEERING
117-120A Project Name: Change Order #:
Mishawaka Avenue Traffic Signals at Fire Station #9 1
Project Number:
DATE INITIATED:6-13-19 m.... BPW DATE: 7-9-19 ........
Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.).
Intersection at Mishawaka Ave/Ironwood Dr. is not up to date. Handholes to be added at each
corner with independent conduit runs to each. Additional concrete work needed to tie everything
together properly.
Attachments: (List documents support change — required)
Price breakdown
Amount of B Increase / ❑ Decrease: ¶16, 638.57
Categories (Pick One):
Previously approved Change Order(s): $ 0.00 ® Scope of Work
............................ .....••••••-...... 8 Differing Site Conditions, Changed Conditions
Current Percent of Change: 9.71 ........ % ❑ Conflicted Specifications and Drawings
New........ �.....,....�,,,,.. �ww..._.�
El Failed Materials
Total Amount: $187,923.94 El Error
❑ Omission
Total Percent of Change: 9'71
❑ Final Quantity Adjustment
,� L7
Funding Secured From: • • ................
(filled out by PM)
RECOMMENDED BY:
Dan Jones
Project Inspector (Print Name) (Signature) (Date)
REVIEWED BY:
Toy Villa 27 .
Construction Manager (Print Name) _. _. (Signature) Y n WWXITITITWWWWmmmIT� (Date)
APPROVED BY:
Roger Nawrot
--
Engineering Project Manager (Print Name) Sig ire) (Date)
APPROVED BY:
Kara Boyles
City Engineer (Print Name) (Signature) (C1 te)
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BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 07/05/2019
,17011 Name 1 oy i I la
...... -----. -----
Department: Engineering _ ..�.�.
BPW Date 07/23/2019 Phone Extension 5920
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Re uired Prior t _�.�.0 _.... t q Board
o Submittal to Boa
BPW Attorney ❑ Attorney Name
Dept. Attorney ❑ Attorney Name
Purchasing
--- ------ ..._ �.
Check the Avou..onfiate Item Tvne Reaulred
LJ Professional Services Agreement L_J Contract
[J
Open Market Contract
Amendment/Addendum
Bid Opening
Bid Award
Quote Opening ❑
Quote Award
Proposal Opening ❑
C/O &PCA No.
Z
Chg. Order, No. 1 ❑
Traffic Control
❑ Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Information
All Submissions
Proposal
F] Special Purchase, QPA
❑ Req. to Advertise ❑ Title Sheet
F-1 Reject Bids/Quotes
PCA
Resolution
Ease./Encroach
Pemberton_ -Davis Electric, Inc. _
Yes If Yes, Approved �
�❑ ❑ pP Y Purchasing
® No
❑ MBE Completed E-Verify Form Attached E]Yes
WBE ❑j No
........ i Mishawaka Avenue Traffic Si nals at Fire Station _mon #9y„ ___ m.�..........
117-120A
Div. A - LRSA Traffic Signal Maintenance / Div. B......................
-EMS Capital
Fund
�... ............... - - --_ m...m.,mm._ ..m._. ......_.
1.0608.431.36.67 / 287.0902.422.42.02
AVproval of C.O. #1
Change Orders On ...__ ��. .�
�............._...µ........... _ For .................. aY _____----__
Amount of z Increase $ 16,638.57
[ j Decrease ($ )
....................
Previous Amount $ 171,2
........... ---_____-
. .. M_..
85.37
.e�Increase... ... 9.71 %.... ...�., �—_......, ....... ..W�.
Current Percent of Change: Decrease,_ �m ..m.,%).,_ .. New Amount $ 187,923.94
...........................................
Increase %
�.............................. ........ ..
----------------
Total Percent of Change: Decrease'9.71%
Time Extension Amount:
..... -- ......... ----- ------ ----.___...-_...................__..... ...... ........ _..... .—
New Completion Date: